Comment by evolve2017 | Hacker News Reader

Comment by evolve2017 | Hacker News Reader

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I'm unfortunately on mobile and can't write much - however, my understanding is that there is still some debate about the benefits of medication vs sanitation in overall mortality in Western countries. While this doesn't necessarily hold true for children, I thought I'd link to a discussion of this debate. (Can't find the reference I wanted...)

Here's a figure for death from infectious disease by the CDC - note that antibiotics don't appreciably change the rate in decline

https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4829a1.htm#fig1

just a random find - this paper from 1902 mentions the debate, too, with some descriptions of 'natural experiments' https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2401255/?page=1

Also, I am not saying that antibiotics and medications don't work - just that the story actually is more interesting than one might initially guess.

Lastly, these data discuss Western populations - I've heard the opposite may be true in poor countries.

Amazing how sanitation caused polio to drop rapidly for years without having an effect on measles, then suddenly measles starting dropping. Or we can just notice how the drop occurs right after the introduction of the vaccine.

I did not mean to be belligerent in my response and I'm sorry if I offended you.

As I said above, in the Western world, sanitation and other interventions both contributed to our current state of health. As the graph I linked to shows, antibiotics haven't appreciably changed the rate of decline of infectious disease. This is no way means that antibiotics and/or vaccines are ineffective. As you point out, looking at specific diseases shows that these interventions are helpful.

Here's the data for measles if folks are interested - there was indeed a remarkable drop after the institution of the vaccine[1].

1. https://www.quackwatch.com/03HealthPromotion/immu/immu01.htm...

I think I'm outside the edit window for my comment. As a coda, it looks like mortality due to measles may have been declining before the incidence of measles began to decline; this further supports a role for other societal developments in decreasing death from infectious disease.

This is purportedly related to the use of antibiotics to decrease bacterial sequelae of measles. I saw an academic reference to this effect but I can't find it again - here's a popular article. You'll note that this commentator ascribes some of the decrease in measles-related death to sanitation.

1. http://www.iayork.com/MysteryRays/2009/09/02/measles-deaths-...

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